Friday, January 30, 2015

Can your smartphone help you exercise?

Fitness applications (apps) use behavior change techniques (BCTs) to
help users modify their physical activities, but which apps and which
techniques are most effective? In a study in the American Journal of Preventive Medicine,
researchers evaluated 100 top-ranked physical activity apps and
analyzed which BCTs are being used in these apps. They determined that
at present BCTs have been only narrowly implemented in physical activity
apps.

As the proliferation of smartphones and other mobile devices continues,
healthcare professionals - and patients - see promising vehicles for the
delivery of health-related interventions to large segments of the
population. More than 50% of American adults own smartphones and half of
those owners use their phones to search for health information.
Approximately 50% of mobile subscribers use a fitness app.

In the current study, trained inspectors using a classification scheme
of 93 specific BCTs examined each app to determine the presence or
absence of each BCT. Overall, only 39 of 93 possible BCTs were found,
with an average of 6.6 in each app. The most commonly observed
techniques involved providing social support via online communities
(e.g., Facebook, Twitter), information about others' approval,
instructions on how to perform a behavior, demonstrations of the
behavior, and feedback on the behavior.

"Two types of apps emerged based on their BCT configuration, and those
classes roughly paralleled those identified from an analysis of online
descriptions of app features," commented lead investigator David E.
Conroy, PhD, professor in the Department of Preventive Medicine,
Northwestern University Feinberg School of Medicine. "User inspection
revealed the ubiquity of social network integration across the two
classes of apps, and the emphasis on feedback for motivation (as
compared to techniques such as goal setting). These findings reinforce
the conclusion that all apps are not created equal, and prospective
users should consider their individual needs when selecting an app to
increase physical activity."

According to Dr. Conroy and co-investigators, most apps use a limited
set of BCTs, and developers have favored BCTs with a modest evidence
base over others with more established evidence of efficacy. For
example, social media integration for providing social support is more
commonly integrated in apps than the more well-established BCT of active
self-monitoring by users.

The lack of self-monitoring in physical activity apps might be an
unintended consequence of the sophisticated sensing capabilities of
mobile devices. With embedded accelerometers passively monitoring
movement, the user has little incentive to participate and may lose the
benefits gained from retrospection and active self-reporting.

Apps that increase physical activity levels are potentially valuable
because insufficient physical activity is the second-leading preventable
cause of death in the U.S., with links to heightened risk for major
non-communicable diseases. "The information resulting from this study
will be valuable for scientists and developers working cooperatively in
the mobile health domain as well as physicians and other practitioners
who seek low-cost interventions to increase their patients' physical
activity," concluded Dr. Conroy.